Opinions - Am I crazy for insisting that I don't be given a SSRI/SNRI for anxiety?

[GForce]

Just a quick foreword, I'm posting in the first person becuase the nature of this post in no way discusses illegal activities. I'm being treated by a psychiatrist for both ADHD and general anxiety disorder, however my doctor and I have recently reached a major roadblock in my treatment. I come to this community to get some second opinions and hopefully some studies or articles that support my opinion so that I may show them to my doctor.

So for a background, I began my ADHD treatment well before my GAD treatment. I've been taking Adderall for about two years now, give or take a few months. It has been extremely effective and helping me treat my ADHD, which is of great concern to me because I am a student at a top 20 university so my workload and difficulty I encounter aren't exactly easy. But as I mentioned, Adderall has been effective at helping me manage my course and workload. My doctor has no objections to this route of treatment, in fact I was up to my current dose (20mg IR 3 times a day) after only 2 months or so of titrating upwards. It has also given me the added benefit of weight loss, which is a problem I've been struggling with my entire life. Given that I am overweight I was concerned that such a high dose of Adderall could harm me, but my doctor had me take a physical and such and concluded that I can safely take this dose.

In May 07 I was living in New York City for the summer as I had an internship there. I continued seeing a pyschiatrist there as Adderall cannot be refilled. Although I had expressed my concerns of anxiety to my actual psychiatrist for quite a few meetings before I left school for the summer, he didn't seem eager to begin treating it with medicine. He insisted that I try therapy with him first, but he did give me the option of taking medication if I thought that would be the best option for me. I gave therapy a shot with him and found it largely unproductive, and requested that I recieve a pharmaceutical to treat my symptoms. Because of the timing of me addressing my anxiety issues my doctor didn't have much of a chance to explore medicinal routes and I don't blame him.

Fast forward back to May in NYC and I'm seeing a psychiatrist primarily to recieve a refill for my Adderall every month. However I picked up where I left off with my real psychiatrist and explained my problems with anxiety and that I was seeking a way to medicate the symptoms. He wrote me a prescription to Klonopin and by June we found an effective dose, 2mg twice a day. Klonopin has had profound effects on me as it virtually erased my social and general anxiety. It also pretty much stopped my panic attacks since its a short/medium acting benzodiazepine unlike Xanax which is more effective for treating an attack when you're having one or think you may have one. Klonopin allows me to take my doses and go on with my daily life, even towards the time when plasma concentration would be lowered (for instance an hour or two before I take another). Because of its slower effects the medicine is always working to some extent to treat anxiety or panic attacks. Granted, I still have panic attacks from time to time, but they're exclusive to when I'm not taking Klonopin or I took it a long time ago. So basically the medication has been very effective because of these positive effects.

Fast forward again to September 07 when I returned to school. I resumed seeing my regular psychiatrist and updated him on my new treatment. Immediately he was unhappy. His first response to me was that not only am I now addicted to Klonopin but if I stop taking it I can have siezures or even die. This wasn't new to me because I always thoroughly research any drug I am prescribed, not to mention the psych in NYC of course warned me of this. He immediately suggested a very slow tapering off of the Klonopin to be replaced by a SSRI or SNRI until we found one that works effectively. As far as SSRIs and SNRIs go, I had already done my research as I inevitably stumbled upon the information while researching anxiety. I replied to him that the side effects are very undesirable by me, and that I have a fair amount of friends who have taken them for either depression or anxiety. 95% of them told me it was awful and they stopped taking it. They said it made them feel like zombies and in some case worsened their problems (which is something I wasn't surprised to hear given my research). The only exceptions to this are two people I know, a friend who has a small case of being bipolar and my brother who has been using Effexor XR with success in treating his depression. He's 15 years old now, but has been taking it for 2-3 years. I believe he is better off with it than without it and he hasn't had serious side effects because he was definitely in need of an antidepressant.

I know that SRIs are approved for the treatment of anxiety disorders, but they're still antidepressants. Researchers believe that anxiety is the result of low serotonin levels so I can understand why a SRI could be effective for treating anxiety. However I'm not depressed and therefore I don't need treatmnet for depression. I'd rather take a medication that is specifically targeted at treating anxiety, not an antidepressant that is treating me for more than what I need to be treated for. The main concern my doctor expressed to me is that benzodiazepines are dangerous to stop taking abruptbly because of how they're habit forming. But Adderall, at least to me and I'm sure many others, is equally as habit forming. I couldn't see myself getting all my work done or even be motivated to work without Adderall. If I don't take it I'll feel like crap because my CNS is used to being stimulated. If I don't take the medication I don't feel worse than baselline, but comparatively I feel like crap because I don't have a stimulant motivating me to get involved in things. I'm not concerned about this dependancy nor is my doctor. We see eye to eye here because of my quality of life with Adderall versus without, plus the fact that I am physically healthy enough to take it.

I have no plans on discontinuing Adderall nor do I plan on discontinuing Klonopin if things go my way, because in my eyes both are habit forming and, in the case of Klonopin, I have no intentions of stopping it abruptly because its a useful medication to me. If the largest health risks are from an abrupt stop, I'm not at risk. Why would I just stop taking something if it has had profound effects on my quality of life? It is for this rerason I don't understand my doctor's concerns, especially in the context of replacing Klonopin with an antidepressant. Aside from my grievances with antidepressants (which I'll go into next) logically I can't see a difference between them and Klonopin. The one difference I do see is that Klonopin treats my anxiety and has been effective while I have no experience with antidepressants and they treat more than what I need to be treated for. Both are very dangerous to stop taking abruptly, so I really can't see the difference. If he's so worried about the side effects and discontinuance of Klonopin, I don't understand why he'd be worried about the same with an antidepressant. In this sense the drugs are identical; they both require you to take them regularly and they are both dangerous to stop taking without tapering off.

My largest grievance is simply the fact that I don't want to be drugged up 24 hours a day in order to overcome my anxiety. Like I did with my ADHD, I want to take a medication that will treat the symptoms and help me function, at least through college. I am not thrilled about the fact that antidepressants work to permanently change the chemical balance in your brain for the duration you take them for. In addition, with Klonopin when/if I need to discontinue use, I can taper it off and be done with it. With antidepressants, even with tapering them off, patients can have very bad side effects for a long period of time following the cessation of use, side effects that include depression, suicidal thoughts, weight gain, and anxiety, to name a few. These are the same side effects that one can experience beginning a SRI treatment, many of which are undesirable to me. As mentioned earlier, I've struggled with weight my entire life. Given that it takes 2-4 weeks for the effects to be realized, and that my doctor believes we'll have to try a few before we find the right one, this is one particular side effect I am very turned off by. As far as my research has indicated, the reason for the weight gain side effect is largely a mystery. For whatever reason it causes your body to store more energy than normal, energy of course being fat molecules.

Aside from those two complaints, another one is of particular importance to me. Another regular side effect of SRIs is ANXIETY! And this particular side effect can be felt either at the beginning, during, or end of treatment, and any combination of the three. Given how SRIs work pharmacologically it could be months of drug-induced anxiety before I find a drug that works. Also, given the adverse reaction from stopping the use of them I find that a SRI is too much of a long term "solution" to my anxiety. I don't want to be on a drug for the rest of my life, and I believe a SRI would create such a situation (maybe not lifetime, but at least 2+ years to finish school, and then however many more years I need it) where I would be indirectly forced to continue taking them because if I didn't the results could be devastating.

For me, it seems like a lot more trouble than it's worth. The side effects, opposite effects, neccesity for trial and error with different SRIs and the months that would take, and the necessity to continue taking the medication everyday for a long period of time seem like overkill to me. Klonopin works and it works well. If it ain't broke, don't fix it. I understand I can't take Klonopin for the rest of my life because studies have show adverse effects of long term use of benzodiazepines, but I'm really only looking for short-term treatment because much of my anxiety is the result of my studies and the university environment. That's not to say my anxiety will disappear after school, but I can probably switch to a lower dose of Klonopin or Xanax to just treat anxiety when I have it. Even then, if short-term develops into long-term, I can taper off and stop without side effects that can last up to a year or longer which is the case with SRIs. I understand I'll feel crappy the first weeks I completely stop taking a benzodiazepine I've been tapering off, but I don't need to worry about having these side effects for a year or more.

My doctor still insists on SRIs and has (very slowly) reduced my dosage of Klonopin in preparation for the possibility of combining it with a SRI, or replacing it all together. The reason for this is that he wants me to have another physical to see if I'm healthy enough to be taking both. Fair enough to me, and he did ask me a few months ago to get one done, but I've been so busy that even when I made an appointment for a physical I had to miss it for one reason or another. He told me that if the physical meets his approval he'll be more inclined to allow me to continue my regular regiment, but I don't completely believe him. Given our interactions I have my suspicions that once I do get a physical done he still won't want to prescribe me Klonopin, regardless of the results. He firmly believes in antidepressants and has told me they're by far his preferred method of treatment for anxiety. The dislike he expressed for benzodiazepines is enough for me to suspect this, so my physical really isn't the determing factor here.

The determing factor is his opinion. I've expressed my own on numerous times and discussed the facts I know with him but honestly in any doctor's mind they're going to give themselves much more clout than a patient. He's offered me a referral to another psychiatrist who wouldn't care about prescribing the two but being as I've been his patient for around 2 years now I've developed a strong patient-doctor relationship that I don't want to lose. I am torn though because I firmly believe that a SRI is not for me, even though it may be effective for some. I know it is the preferred way of treating anxiety nowadays but I still oppose it because I want to treat symptoms, not my brain chemistry.

If anyone has any insight into this situation or a useful article/study that could support my argument, or even one that debunks it, I would appreciate it. Given how serious I am about thinking SRIs would be dangerous for me I don't plan on accepting a prescription to them, and my best weapon I could use, to maintain being his patient and my current treatment, is scholarly sources that support my argument (but feel free to present a different viewpoint). Thanks for your help and for reading this long post.

Reputation Comments on this post:

	very informative, I'm in a very similar situation
	Nice descriptive post, hope you get things worked out.

[rodent]

You're certainly not crazy wanting to stay away from SSRI's. Sorry I don't have any resources that will help you though.

I guess the only thing I have is experience so, I'll share that. All of these pharms can cause nasty withdrawal effects. I have tapered off xanax and zoloft (never had to taper with adderall). The absolute worst thing I have ever had to go through is benzo withdrawal. The second worse is the ssri withdrawal. Both are long and drawn out ordeals that you don't want to go through.

Sounds like you've done your research which is really the best thing you can do before taking rx drugs. Good luck with your anxiety and your doctor.

[razorwiredildo]

if the combo of adderall and benzos works for you than there is no reason to try something else.
While ssri can be used effectively for anxiety, they definately can make you feel like shit.
You are not crazy for not letting the doctor pump you full of whatever he feels like. He is wrong to pressure you into taking a drug that you do not want to take.
Remember what they tell you in school: Just Say No. even if the doctor recieves a little extra money from pharm comanies to prescribe their drugs.
Good luck getting things worked out.

[Laudaphun]

After trying almost every SSRI, SNRI, etc I've heard of, you couldn't pay me enough to get me to start taking another one. I have ADD and GAD also and I absolutely will refuse any further SSRI/SNRI for anxiety. The only way anyone could convince me to take any of them again would be if I was to become extremely depressed and WANT to "just not care" which is exactly how these meds make me feel (along with the plethora of side-effects).

With that being said the older (tricyclic anti-depressants) or TCA's... well I started taking Tofranil (imipramine) which was the first of them to be invented has caused me no side-effects at all. Even though I was told that 1 in 6 people would discontinue it due to side-effects. I don't get it. I was so scared to begin taking it that it was 2 full weeks after getting the prescription filled that I tried it... Memories of zoloft(sertraline), paxil(paroxetine), effexor(venlafaxine), cymbalta(duloxetine) etc still haunting me. I have yet to get any real noticeable side-effect with this tricyclic AD.

I think it's funny how many people (including myself) have an extreme distaste for SSRIs/SNRIs yet their doctors just cycle them from one to another and keep telling them to be patient and that eventually they will find one that works for you... Well, maybe I'm just the oddball or maybe I am not on a high enough dose (50mg imipramine/day) or maybe I haven't taken it long enough to get side effects but it appears to be the first anti-depressant of any type that I have been able to tolerate. On the other hand, it was actually prescribed for social anxiety and I cannot tell if it has helped yet.

Ironically, it was my grandpa who has EXTREME panic disorder/anxiety issues that told me the first med to really help him with his anxiety was tofranil(imipramine)... back when he was dealing with the doctors, most of these newer SSRI/SNRIs did not exist. In fact he was originally prescribed meprobromate for his anxiety problems because benzodiazepines had not yet been introduced to the market. When he told me about tofranil, i didn't think much about it since I figured it would just be like all the other stuff I'd tried.

[Broshious]

Originally Posted by Laudaphun

After trying almost every SSRI, SNRI, etc I've heard of, you couldn't pay me enough to get me to start taking another one. I have ADD and GAD also and I absolutely will refuse any further SSRI/SNRI for anxiety. The only way anyone could convince me to take any of them again would be if I was to become extremely depressed and WANT to "just not care" which is exactly how these meds make me feel (along with the plethora of side-effects).

With that being said the older (tricyclic anti-depressants) or TCA's... well I started taking Tofranil (imipramine) which was the first of them to be invented has caused me no side-effects at all. Even though I was told that 1 in 6 people would discontinue it due to side-effects. I don't get it. I was so scared to begin taking it that it was 2 full weeks after getting the prescription filled that I tried it... Memories of zoloft(sertraline), paxil(paroxetine), effexor(venlafaxine), cymbalta(duloxetine) etc still haunting me. I have yet to get any real noticeable side-effect with this tricyclic AD.

I think it's funny how many people (including myself) have an extreme distaste for SSRIs/SNRIs yet their doctors just cycle them from one to another and keep telling them to be patient and that eventually they will find one that works for you... Well, maybe I'm just the oddball or maybe I am not on a high enough dose (50mg imipramine/day) or maybe I haven't taken it long enough to get side effects but it appears to be the first anti-depressant of any type that I have been able to tolerate. On the other hand, it was actually prescribed for social anxiety and I cannot tell if it has helped yet.

I had a similar experience. SSRIs were pretty shitty. Then I went on Nortriptyline, another TCA, and the only side effect was, admittedly bitchin' dry mouth.

[Laudaphun]

Originally Posted by Broshious

I had a similar experience. SSRIs were pretty shitty. Then I went on Nortriptyline, another TCA, and the only side effect was, admittedly bitchin' dry mouth.

Yes! That's it, I've also been noticing this unquenchable thirst... I wasn't completely sure if it was the imipramine or not as it has only been a few weeks and I do not drink nearly as much water as I should, but other than that no real bothersome side-effects.

Something else I'd like to add that I figure would likely be of interest to many people is that I've noticed NO sexual side-effects with imipramine.

[Laudaphun]

GForce,

have you noticed any reduction in your memory or attention span due to taking the klonopin(clonazepam) during school, or do the amphetamines reduce the anxiety reducing effects of the klonopin? I've been wondering about this combo as the two meds would seem to have an antagonistic effect on one another.

SWIM is also in the position of needing to take both ADD meds and benzos, however he is afraid to take them at the same time and afraid to take the benzos at school very often. The most normal SWIM has ever felt was as far as his GAD/social anxiety was when he was after he had been taking a daily dose of librium(chlordiazepoxide) and it had built up in his system... But then SWIM got to thinking that maybe the steady effect of the benzo in his system might hinder his performance in college, so he discontinued the regular dosing shortly after the fall semester started as his course load is very difficult.

Basically just looking for some advice as you and SWIM seem to be in similar situations. Sorry about the back to back posts.

[GForce]

I haven't found any loss of memory for the most part. If I take a particularly large dose (I'm allowed up to 3mg in the case of a severe panic attack) then my memory can become a bit blotchy, but the dose I take works more in the background to keep me calm than giving me any recreational high. I take it routinely before exams so that I don't get distracted or work slowly due to anxiety and I have no problem remembering answers. I take it while I study as well for the same reason.

[Laudaphun]

You know, I have that same problem with studying. When I sit down a try to study, my mind will just start to wander and then suddenly I realize I'm not reading or studying what I was try to. I get to see my psychiatrist in a few days so hopefully we can arrive at a solution. The spring semester will be a real test to see if the ADD medication helps. I do need to be treated with both a stimulant and benzo combo but I'm hoping for a short-acting benzo. In addition, the imipramine still seems to be pretty mild as far as side-effects go. I also did some reading and imipramine also has uses in ADD... I was actually pretty surprised to discover its uses other than as an anti-depressent.

It's really tough when you get to see your psych dr. as you have so little time that you almost have to be prepared before you go in with stuff. I keep a journal that I make entries into when something pops into my head that I think I need to tell my dr. I always leave and later think of stuff I should have told him but forgot.

[plur]

in theory adderall it self could couse anxtiy all though swim think unlikely it still something that should at lest talk about with the doctor

swim personaly think the use of benzos to treat any thing in the long term is generly a bad idea smiw knows a few people whose condition got worse over a few years of being on them becouse of the reboud effect of these meds as one body starts to tolart the drug

swim is not a doctor but for some reson all the people swim knows seem to be involed in pyhcolagy in one way or another

[GForce]

Adderall can certainly be a catalyst for anxiety, which is why perhaps my doctor doesn't want to start treating symptoms of other medications. However I've had anxiety my entire life, I just never sought medical attention for anything until I got to college and my ADHD was making it hard for me to continue to do well. Now that my ADHD is treated I really couldn't imagine getting work done without medication. Granted I don't want to be taking drugs my entire life, but to me school will always be school and just a task to complete. Hopefully my going to school will let me do something I enjoy and look forward to doing so I don't need the extra motivation. But while I'm studying weather and atmosphere to just complete a natural science distribution, I need that extra motivation to keep my mind focused on the subject when I don't care about it at all. As far as long-term treatment with benzos go, I think the term long-term is subjective. Some people believe its only a few months (my psychiatrist) while others thing that it can mean a few years, such as the years needed to complete an education (my mother's psychiatrist believes this but I live in another state than him). If there is an effective combination to overcome the current hurdles than might as well use it, and then address the problems more intensively when the patient can afford to take the time to do that. Thats how he feels and I feel, but my psychiatrist doesn't share that sentiment. When I go see him in a week or two I'm going to basically tell him this probably and if he can't work with me I'll have to find a new doctor. Would be a shame though because I've known him for two years now.

Just the fact that I don't want to take medication my entire life should give more credit to my "no SSRI" sentiment. SSRIs become a way of life for some people and while I have nothing against people who geniunely need them, I don't believe I fall into the category. I don't think my doctor has explored depression enough with me for the simple fact that he's never even brought it up. At least a benzo he can ween me off of, which won't be fun, but won't leave me with the intensity or duration of problems you can get from a SSRI stoppage. I know benzos aren't pretty either, but given the nature of how a SSRI or SNRI works and my reaction to medication I think I would have a much more difficult time stopping treatment with a SRI agent.

[GForce]

So I finally met with my Psychiatrist today because I needed refills for my meds. When we first sat down he flat out told me that we're at the end of the road and that I need to make a decision. Granted, I take full responsibility for not seeing an internist yet, but I genuinely plan on doing so if just for my yearly check-up because I've now been using Adderall for over a year since my last physical before I started my prescription. So, what my doctor did was prescribe me two weeks worth of my Adderall and my Clonazepam. He told me that if I want to continue treatment with him I need to see the internist within the next two weeks and call him when I do so that he can get me in to his office. His plan, which he seems very adamant about, is to hold my Clonazepam at 2mg a day while introducing a SSRI and tapering the Clonazepam off when we finally find something that works. I don't hold anything against him or anything like that. I understand and appreciate that different doctors have their respective preferences and comfort levels with specific medications. He even went as far as to give me three names of other Psychiatrists and Psycho-pharmacologists if I decided that I didn't want to take the SSRI route.

Of course every doctor is different. My particular doctor said he would feel comfortable with me on 60mg of Adderall a day, 2mg of Clonazepam, and whatever SSRI we're titrating. To him, the difference between 4mg and 2mg is gigantic, to the point where he decisively said that he won't, under any circumstances, continue to prescribe me 4mg of Clonazepam a day, but said that he would have no problem with 2mg. To me I think that whole situation is a bit ridiculous because his main gripe was its addictiveness and yet if I'm taking 2mg a day I'll still maintain a dependency.

He is also concerned about cross tolerance issues between Marijuana/Alcohol consumption along with my medications. I think it is unfair for him to label me a risk when I've been doing nothing but reducing my consumption of both. Today when he asked me about the last time I drank I told him that I haven't had a drink since coming back to school. Over the past 6 months I have been showing a trend of decreasing my substance abuse substantially (I barely even drink anymore, and if I do it isn't much) and yet he maintains his conviction which is a bit upsetting to me.

All and all I think I'm going to have to end up changing doctors. Regardless of how my physical goes my doctor wants to start me on a SSRI. I wouldn't even have a problem with experimenting with SSRIs and Clonazepam until I found something (or if I found something) that worked if it wasn't for the fact that I have a very rigid schedule for classes and this semester just started. My previous treatment was working great; I ended last semester with the highest GPA I've obtained yet. However my enthusiasm is limited because I don't want to spend would could be a semester or even longer finding a medication that works when Clonazepam already works. Call me stubborn but as I said earlier if it isn't broken there is no need to fix it. Personally I'd like to just finish out this year of University without experimenting on drug combinations and using what I know will work.

I could go on and on but doing so is just exacerbating my anxiety even further. I need to figure out what I'm going to do and fast. It is unfortunate that I don't see this relationship with my current doctor continuing because I find him to be a genuinely caring and honest person who is doing what he thinks is best for his patients, but looking forward to two weeks I can't see a solution that involves the medications I need and him as my doctor. At this point, being well over half way through with my undergraduate studies I just want to finish on a high note which my med combo has been allowing. I don't want my doctor to start messing around with everything while I wait to see if the SSRI is going to make me depressed or more anxious or actually help me. I do believe that SSRIs are powerful tools for the long-term treatment of anxiety, but honestly I think its reckless to be experimenting with changing my whole medication routine, especially when I have less semesters of courses left than I've already taken.

So I guess I'm going to first contact the University and see how useful their mental health services can be. If I'm lucky I won't need to leave campus and I'll have a doctor who will treat me the way I feel comfortable. Otherwise I'm going to have to take a shot with my eyes closed and hope I get another doctor as compassionate and knowledgeable as he was. What a shitty situation.

[upperdecker]

Hell no, SWIY isn't crazy. SWIM told his psych. numerous times that he can't handle SSRI's for numerous reasons and the doc. always pretends like SWIM never told him he won't take SSRI's. If SSRI's didn't make you feel like a zombie/sexual side effects/the withdrawal/blocks effects of other drugs, then SWIM would be more than happy to take them.

[Orchid_Suspiria]

Swiy is not crazy at all.One thing swim hates that many doctors do is try and tell people how to feel,tell them what should work for them,not suggest but tell.Swim avoids ssri's like the plague.

[saorsa.elegy]

I have been treated for anxiety and depression with benzo's and ssri's. I can attest that the tapering off sucks. I was very sick, and am still on the tapering. It has been a long time. I think that if your doc is listening to your worries then you have made a great start!
I have learned to maintain my anxiety with self hypnosis.
I desperately want to be off of my meds!! I am down to the ssri. I should be done in one month!
You are NOT CRAZY.

[salviablue]

SWIM with anxiety, started treatment on venlafaxine, which worked fairly well at controlling the "overwhelming impending catastrophic event" feeling and the over irritability and IBS caused by being in a semi-permanent "fligh or fight" response mode. Problem was withdrawal, esp. if they forgot to pick perscription after running out! BRAIN SHOCK + SENSORY JARRING!
Venlafaxine was phased out of British perscriptions and SWIM was introduced to Citalopram. This wasnt as effective but still works. Swim informed me that after maybe a year on citalopram (or clitorispam as s/he once told a doctor!) gradual reduced strength to the minimum eventually seemed to work just as well as the initial stronger doses.
However, the withdrawal are just as bad, although takes longer to build up.

SWIM informed me that s/he discovered whilst in Amsterdam, s/he had forgotten to take with his/her tablets (whilst on venlafaxine). Towards the end of the holiday the brain pain was unbareable, reflecting that psilocin may flood the synapses with seratonin, mushrooms were ingested. These worked in completely reversing the toxic withdrawal effects from venlafaxine and v.pleasant trip ensued. The effect of withdrawal reversal was asthough the actual script tablets were taken.

Since then, whenever SWIM frogot his/her tablets for a few days, mushrooms were ingested (subject to availability).

More recently, since moving onto citalopram, SWIM has noticed that both psilocin and free base bufotenin (or maybe Calcium Bufotenate) have good anti-withdrawal actions and even seem to continue the supposed effects of the ssri. SWIM had starting experimenting with sub-psychedelic doses (well just a few liberty caps) of shrooms, but with supply being seasonal and sporadic, Cebil experimentation has begun, albeit with slightly less successful results as yet. The shrooms worked really well in place of the ssri, and seemed to be fairly interchangable with the ssri (although prescence of the ssri altered the effect of the shrooms, dependant on the ssri`s half life). The Cebil experimentation has only just started and as thus SWIM cannot really make too many comments upon the effectiveness of Cebil (, plus the occurance of extreme nasal discomfort greatly discoloures the usefulness of the cebil vs ssri experiment).

This is what had worked for SWIM in the past, and if psilocin was freely available all year round, this would be swims prefered way of dealing with anxiety.

(This has been posted in another thread and wasnt sure wether or not to link it or quote it? Sorry if this is wrong)

[tryptamaster]

swim does have esver depression and still avoids ssri.s. the only anti depresent he has taken was wellbutrin an it was wayyyyyy shity. swims doctors ALWAYS seems to wana push ssris, wat is it wiht docotrs and swearing by sssri? swim is also on clonazepam but would prefer a shorter acting benzo like alprozalom or lorazepm. anyone know y docs alwyas push ssri?

[Jacco]

Originally Posted by tryptamaster

swim does have esver depression and still avoids ssri.s. the only anti depresent he has taken was wellbutrin an it was wayyyyyy shity. swims doctors ALWAYS seems to wana push ssris, wat is it wiht docotrs and swearing by sssri? swim is also on clonazepam but would prefer a shorter acting benzo like alprozalom or lorazepm. anyone know y docs alwyas push ssri?

Probably because SSRIs actually create lasting changes in terms of serotonin levels, so you can eventually discontinue medication. Wellbutrin, on the other hand, I don't think has any long-term effect.

I'm currently on 30mg fluoxetine/day, and 0.5mg clonazepam as needed. My doctor wanted to reduce the fluoxetine to 20mg/day, but I refused because I am NOT putting up with OCD anymore. Different things work for different people, and it makes me tired enough to cause problems with school, but in my mind it's worth it.

The reason they don't keep people on benzos to treat anxiety disorders is that tolerance and addiction will always happen. I've already noticed a decrease in effect from the clonazepam I take, and I take that maybe 4 times a week now. SSRIs don't have low LD50s and they don't cause tolerance. Fluoxetine is the best SSRI imho, because the half-life is long enough so that withdrawal isn't really an issue. Paroxetine and the others can be quite nasty though.

2mg twice a day will definitely get you into a lot of misery. I have considerable amnesia even after 1mg, but I guess everyone's body chemistry is different.

[doggy_hat]

Originally Posted by tryptamaster

swim does have esver depression and still avoids ssri.s. the only anti depresent he has taken was wellbutrin an it was wayyyyyy shity. swims doctors ALWAYS seems to wana push ssris, wat is it wiht docotrs and swearing by sssri? swim is also on clonazepam but would prefer a shorter acting benzo like alprozalom or lorazepm. anyone know y docs alwyas push ssri?

SWIM has tried Welbutrin, and it actually worsened the depression. He's not sure if more severe depression could be worse, than being a dry-mouthed zombie though.

Also, I'm no pharmacologist, but would combining adderall and Klonopin be a bad idea? Because one is a strong stimulant and the other one is a strong sedative, and I've always thought mixing upers and downers was a bad idea.

[chillinwill]

Originally Posted by doggy_hat

SWIM has tried Welbutrin, and it actually worsened the depression. He's not sure if more severe depression could be worse, than being a dry-mouthed zombie though.

Also, I'm no pharmacologist, but would combining adderall and Klonopin be a bad idea? Because one is a strong stimulant and the other one is a strong sedative, and I've always thought mixing upers and downers was a bad idea.

SWIM's doc put him on a combo of suboxone, k pins, and adderall and it never hurt SWIM but he is wondering now why would a doc prescribe 2 downers and a stimulant although all of these were taken at prescribed doses

[Smoolio]

SSRI's are all different and have varying side effects / withdrawal symptoms / effectiveness.
To pool them all into the same bag is kind of wrong.
I personally wouldnt avoid a medicaiton simply because of some bad side effects which happen early on - there is no such thing as a magic pills as my doc would say.
I suppose it really depends on how badly you want some relief.

[yaba]

Swim was on fenlafaxine for general anxiety disorder (GAD) he stopt after learning thats its crap ! Now he gets some diazepam from the doctor only in small amounts 5mg take when required. More could be bought swim told me..

Swim talks to friends some with jobs in the medical world and they all agree that SSRI and SNRI arent the right medications to treat anxiety.

Swims GP is more then happy to give him venlafaxine or releted compounds. Not easy to get a prescription for diazepam where swim is living.

[seeingred]

Swim took zoloft for about a month and noticed, significant decrease in anxiety. Swim also noticed that SWIM felt a lift in mood, because swim was depressed and seriously not caring about nething. The zoloft didn't have huge side effects, but swim's mind has been a little more clear and focused....swim's parent was on prozac and became suicidal/a wreck. But swim is being careful about zoloft, not taking too much. Swim might worry that a mixture of a SSRI and Adderall, might make the risk for side effects worse as well as make the need for a lower dose imporant...just a guess.

[Richard_smoker]

every person is different. with that being said, if you are one of the MANY people who find that an appropriately-dosed SSRI is helpful at improving anxiety, and elevating moods, then you will be FAR BETTER SERVED taking the SSRI than a daily benzo like klonopin.

realize that the adderall has already lowered your seizure threshold. this means that you're already more likely to have a seizure simply because that drug is a CNS stimulant. As your doctor implied, stopping the klonopin will further decrease your seizure threshold, especially if you've been taking it for a few months or longer with the adderall.

now, i will say that there are definitely some people who are prescribed both drugs, and apparently they need both, and get benefits from the combination. but any physician who allowed you to slip into a combination-addiction on their watch without FIRST trying a whole slew of SSRIs and other options, wouldn't be worth their salt, and would likely have their DEA license evoked soon enough, leaving you in a precarious position. -DICK

[dyingtomorrow]

I don't think you are crazy at all.

SWIM has tried all manner of anti-depressants, and found SSRIs to be among the worst for a number of reasons. More serious depression, difficulty urinating, and an inability to have an orgasm (affecting his sex drive and relationship with his girlfriend, which was one of the few positive things helping him through everything) are three of the main ones. SWIM just doesn't understand doctors.

Opiates were the only thing that made SWIM actually want to be alive, but since you have to do all your own medical research since doctors don't even know what the drugs they prescribe do anymore, and then fight them to give you something that works instead of whatever new toxic synthetic poison the drug company rep told them to sell people, all the while paying $50+ a visit while the doctor "starts slow, trying different things" each week to milk you; well, SWIM just took matters into his own hands.

It's too bad what a puritan piece of shit society we live in, where people are only allowed to legally buy recreational drugs (i.e. alcohol) that make you angry and dumber, not calm, happy and/or introspective.